Health insurance: Nice to have it; everyone needs it

My medical test results recently arrived in the mailbox. Cholesterol, blood glucose, mammogram and other tests, they all came back fine.

I’m feeling lucky, relieved and somewhat sheepish. That’s because for much of this year, I’ve been complaining. Why should I have to go to the doctor? I’m fine.

I didn’t make an appointment for a physical voluntarily. Aetna, the company providing my health insurance as a Herald employee, forced a choice: get some preventative tests or pay higher premiums.

Paying for family coverage as a single mom, my premiums are high enough. It didn’t feel like a choice. It felt like a gun to the head.

It turned out I hadn’t been in for a checkup since 2009. I’ll admit now that although I felt fine before, it’s better knowing I don’t have some undiagnosed time bomb.

More good news came with the test results. Yes I pay pricey premiums. But no, I don’t owe for what would otherwise be expensive tests. If I had to pay out of pocket, the mammogram bill alone could have topped $400 — nearly half my house payment.

My right to that test without out-of-pocket fees is part of the Affordable Care Act. The health care law commonly called Obamacare was largely upheld June 28 by the U.S. Supreme Court.

According to Gov. Chris Gregoire’s office, since the legislation was signed into law in 2010, more than 1.2 million people in Washington with private insurance and more than 650,000 with Medicare now have preventative coverage with no cost-sharing.

The mammogram I had was hardly free, although I won’t be billed directly for it. So far this year, as a card-carrying member of the commercial insurer Aetna, I have paid $2,028.86 for my family’s coverage. Under the Affordable Care Act, my 25-year-old son is still covered. That, too, isn’t a freebie for me.

For lower premiums, I could choose to cover only myself and my 13-year-old. I want my older son covered as long as possible. Like most 25-year-olds, he is healthy and rarely visits a doctor.

If my grown son’s health-care habits are at all representative of his generation, I suspect that allowing adults under age 26 to be covered under parents’ insurance plans is a safe and profitable bet. Aetna, by the way, earned a net income of more than $1.9 billion in 2011.

Like any type of insurance, you don’t need health coverage until you really need it. A decade ago, one of my children was treated for cancer. Even with insurance, I paid some big medical bills. Without it, I would have been buried by them.

I didn’t like being told by Aetna that I needed to visit a doctor or pay more. What a pain. Whose business but mine is the state of my health?

Yet considered merely in terms of cost, the go-or-else incentive makes sense. Detecting a disease early is more effective, and probably cheaper to treat, than finding it late — to say nothing of too late.

Our health care system isn’t perfect now. It won’t be perfect with the full implementation in 2014 of the Affordable Care Act, which will require the uninsured to buy coverage or pay penalties.

Here’s the thing, though. Call any medical office. Almost before someone asks what’s ailing you, the question is what insurance do you have?

According to a paper published on the federal Centers for Disease Control and Prevention website, the health care law is expected to provide coverage access to 32 million people now without insurance. In Washington, according to Gregoire’s office, 17.9 percent of adults were uninsured in 2010.

Census data cited June 30 by The New York Times showed that just 55 percent of U.S. workers had employer-backed health plans in 2010. That’s down from 65 percent in 2000.

I’m lucky. I complain about it sometimes, but I have health insurance — ready for whenever I need it.